Mutual Obligation Activity Reporting

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First name*

Last name*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Phone*

Email*

Required no. of hours for this fortnight*

Actual Hours fulfilled*

Where hours were completed*

At Home

At a sewing bee

At the Op Shop

List of tasks done.*

Person/Place items delivered to*

Notes

Email

Social Media

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